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PROJECT NAME <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />South Bend Medical Foundation Demolition <br />PROJECT NO 123-076 FINAL COST $1,638,562.50 <br />CONTRACT SIGNED 6/11/2024 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Demolition of the South Bend Medical Foundation <br />WITNESSETH: <br />The work under the above contract between the City of South Bend and the undersigned contractor having been <br />completed, the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever <br />arising under or by such contract, and that the contractor performed the work within the scope of the Specifications and <br />Standards of the City of South Bend which were a part of the above Contract. <br />xecuted this 28th day of_ February ,2025 <br />Signature <br />Gerald Blomber <br />Printed Name <br />The MRD Group, Inc. <br />Company Name <br />4777 W. Lincoln Ave. <br />Company Address <br />West Milwaukee, Wl 53219 <br />City, State, Zip <br />WITNESSESS: <br />Before lone, the undersigned Notary Public in and for said country and state, personally appeared <br />Gerald Blomberg and acknowledged his/her,,oihkiikerlp the above Project Completion Affidavit on <br />� <br />the 28th day of I" ebrUarV , 242��.; � '0() UPN1A./r_ <br />l <br />RY <br />Notary Si tore 'may Co.rrrmission Etpires May 6 2028 <br />Mary Okupniak y <br />Printed Name Ci Rye Milwaukee <br />If the Contractor is a corporation, the following cdo- <br />Gerald Blomberaceri�rit IVlE1ryetary of the Corporation executing this release; that <br />Gerald Blomberg Who signed this release on behalf of the contractor was then <br />President of said Corporation; that said release was duly signed for and on behalf of said <br />Corporation by Authority of its governing body, and is within the scope of corporate powers: <br />, . 'm&mt�' <br />Secretalys 9iiFature Corporate Seal <br />Gerald Blomberg No Seal <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable for final approval and we recommend to the Board of Public Works that it be ordained so. <br />,L_44�61t'- _ Date: 7/25/2025 <br />Congkuction Manager <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />7yG.n,,y 4 7-0-, <br />Murray L. Miller, Member <br />1'1:�2_ff <br />Joseph R. Molnar, Vice President <br />Breana Micou, Member <br />Attest: Hillary R. Horvath, Clerk <br />Date: August 12, 2025 <br />